Document Type
Conference Proceeding
Publication Date
3-13-2025
Abstract
INTRODUCTION: The risk factors for developing a periprosthetic joint infection (PJI) are well described. However, those associated with developing a second-site or metachronous PJI (MPJI) following a subsequent primary arthroplasty are poorly understood. The purpose of our study is to determine (1) prevalence and (2) risk factors associated with developing a second-site PJI in patients with a prior history of PJI who undergo a subsequent THA or TKA. METHODS: A retrospective, single-center case-control study identified 77 patients treated for an index PJI (hip or knee) between 2013-2022, and who also underwent another primary arthroplasty after completing treatment for their first PJI. We identified patients from this group who developed a second-site PJI. Diagnosis was made using the 2018 Musculoskeletal Infection Society (MSIS) criteria. Minimum follow-up was 2 years. The prevalence of second-site PJI was calculated, and risk factors were assessed by comparing patients with a single PJI and those with MPJI. RESULTS: 9/77 patients (11.7%) with a prior history of treated PJI developed a second-site PJI after a subsequent primary THA (7/30) or TKA (2/38). Average follow-up was 4.9 ± 2.7 years. Patients who developed a second-site PJI had a significantly shorter onset of index PJI (27.5 weeks) compared to those with only a single-site PJI (104.1 weeks), p=0.003. No other statistically significant differences were found when comparing characteristics of the index PJI, nor for demographic and medical comorbidity data. Average time for developing a second-site PJI was 56.3 ± 72.3 weeks after a subsequent primary arthroplasty. DISCUSSION AND CONCLUSION: Patients with a history of PJI are at high risk [11.7%] for developing a second-site PJI after a subsequent THA or TKA. Orthopedic surgeons should be aware of the prevalence and potential risk factors for metachronous PJI when considering a second hip or knee arthroplasty in this unique patient population.
Recommended Citation
Nikolaidis DA, Young D, Runner R, Karadsheh MS, Steffensmeier A. Second-site periprosthetic joint infection after subsequent primary hip or knee arthroplasty: risk factor assessment. Presented at: AAOS American Academy of Orthopaedic Surgeons 2025 Annual Meeting; 2025 Mar 13; San Diego, CA. Available from:https://index.mirasmart.com/AAOS2025/PDFfiles/AAOS2025-004432.PDF
Comments
AAOS American Academy of Orthopaedic Surgeons 2025 Annual Meeting, March 10-14, 2025, San Diego, CA